In situ kidney insonation with microbubble contrast agents does not cause renal tissue damage in a porcine model.
OBJECTIVE
Knowledge and quantification of the microcirculation are very important for estimating the status of an organ. Real-time contrast-enhanced sonography assesses microvascular tissue perfusion. This technique has been proposed as innocuous; however, data from experimental animals (rats) have shown renal interstitial microhemorrhage after the procedure. Therefore, we developed a porcine model to explore potential renal damage that in situ exposure might cause.


METHODS
Kidneys from 8 anesthetized pigs were surgically exposed. An ultrasound contrast agent (sulfur hexafluoride) was infused through the femoral vein in a continuous perfusion. Destructive ultrasonic flashes were applied with a high mechanical index over only 1 kidney (the contralateral kidney was used as a control). Blinded histologic and laboratory analyses were performed to reveal any lesions.


RESULTS
Histologic analysis of the kidney samples showed no evidence of renal damage. Biochemical parameters that could represent renal tissue damage and hemoglobin levels did not change after the microbubble-ultrasound interaction.


CONCLUSIONS
The ultrasound contrast agent-ultrasound interaction in anesthetized pig kidneys under the output level for the imaging visualization and microbubble destruction used did not cause tissue damage. Our results suggest that this procedure could be used in humans for regular analysis of the kidney microcirculation with minimal risk of tissue damage.
Jiménez
Carlos
C
Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain. cjimenezm.hulp@salud.madrid.org
de Gracia
Raquel
R
Aguilera
Alfredo
A
Alonso
Sergio
S
Cirugeda
Antonio
A
Benito
Javier
J
Regojo
Rita María
RM
Aguilar
Río
R
Warlters
Andrea
A
Gómez
Rosa
R
Largo
Carlota
C
Selgas
Rafael
R
D000818:Animals; D003287:Contrast Media; D006801:Humans; D007668:Kidney / Q000166:cytology* / Q000000981:diagnostic imaging* / Q000293:injuries; D045423:Microbubbles; D023421:Models, Animal; D018570:Risk Assessment / Q000379:methods; D013010:Sonication; D013459:Sulfur Hexafluoride / Q000009:adverse effects; D013552:Swine; D014463:Ultrasonography
D003287:Contrast Media; D013459:Sulfur Hexafluoride